PERSIAN traffic safety and health cohort: a population-based precrash cohort study.

PURPOSE: Despite to high burden of road traffic injuries (RTIs), the RTI epidemiology has received less attention with rare investments on robust population cohorts. The PERSIAN Traffic Safety and Health Cohort (PTSHC) was designed to assess the potential causal relationships between human factors and RTI mortality, injuries, severity of the injury, hospitalised injury, violation of traffic law as well as offer the strongest scientific evidence. PARTICIPANTS: The precrash cohort study is carried out in four cities of Tabriz, Jolfa, Shabestar and Osku in East Azerbaijan province located in northwest Iran. The participants were people who sampled among the general population. The cluster sampling method was used to enrol the households in this study. The PTSHC encompasses a wide and comprehensive range and types of data. These include not only the common cohort data collections such as medical examination measures, previous medical history, bio assays and behavioural assessments but also includes data obtained using advanced novel technologies, for example, electronic travel monitoring, driving simulation and neuro-psycho-physiologic laboratory assessments specifically developed for traffic health field. FINDINGS TO DATE: A total of 7200 participants aged 14 years and above were enrolled at baseline, nearly half of them being men. The mean age of participants was 39.2 (SD=19.9) years. The majority of participants (55.4%) belonged to the age group of 30-56 years. Currently, approximately 1 200 000 person-measurements have been collected. FUTURE PLANS: PSTHC will be used to determine the human-related risk factors by adjusting for the vehicle and land-use-related factors. Therefore, a lot of crashes can be prevented using effective interventions. Although this cohort provides valuable data, it is planned to increase its size to achieve the highest level of evidence with higher generalisability. Also, according to the national agreement this cohort is going to be extended to several geographical regions in second decade.

Comparison between patients with COPD and healthy subjects on spatiotemporal, moment and kinematic parameters: A quasi-experimental study.

Background and Aims: Chronic obstructive respiratory diseases (COPD) not only cause damage to the respiratory system as well as the heart and blood vessels of the patient but also have a direct effect on the condition of the musculoskeletal system. The risk of falling is increasing due to dysfunction of the joints as well as aging, which occurs frequently in this population. Gait deficits are known as an important risk factor for falls. This research aimed to investigate the gait of COPD patients compared to healthy people to gain a better understanding of the reasons for falls. Methods: Twenty patients with COPD and 20 age and BMI-matched healthy individuals were included in this study. Sixteen markers were applied to the lower body of the subjects. Spatio-temporal, kinematic, and maximum moment parameters were measured in different phases in three lower body joints, including the hip, knee, and ankle. Results: The results showed that all spatio-temporal parameters in patients were significantly lower than in healthy people. The ankle angle in the sagittal plane at initial contact was significantly difference (p = 0.03). As well as, in the frontal plane the hip angle in the mid-stance showed a significant difference (p = 0.02). There was also a significant difference in maximum hip moment in the sagittal plane between the two groups (p = 0.01). Conclusion: The larger hip angle of the patients can be related to the balance problems in the mediolateral direction. The moment showed a significant difference in the hip joint. Since the hip muscles are directly in a synergistic relationship with the trunk muscles, it seems the performance of these muscles is likely to be seriously damaged due to respiratory diseases.

Evaluation of vascular graft infection following Bentall surgery using 18F-FDG PET/CT scan: A pediatric case report.

Key Clinical Message: After a Bentall surgery, there is a small chance of developing a serious complication called vascular graft infection. 18F-FDG PET/CT, a new and accurate diagnostic tool, can help detect it early, especially if the symptoms are unusual. Abstract: A 14-year-old boy who had undergone Bentall surgery 1 year prior presented with symptoms of fever, chills, loss of appetite, and weight loss over the course of a month. The initial Bentall surgery was performed due to an aneurysm of the thoracic aorta, along with severe aortic valve insufficiency and moderate aortic valve stenosis. The patient was referred to the PET/CT department for evaluation of possible endarteritis or infection of Dacron graft, which had been reported in trans-esophageal echocardiography as suspicious findings. Despite normal blood tests, blood cultures, and other imaging modalities, the 18F-FDG PET/CT confirmed the diagnosis of vascular graft infection. This diagnostic tool allowed for timely and appropriate treatment and prevention of possible complications.

Effects of flaxseed supplementation on weight loss, lipid profiles, glucose, and high-sensitivity C-reactive protein in patients with coronary artery disease: A systematic review and meta-analysis of randomized controlled trials.

This meta-analysis aimed to evaluate the effects of flaxseed supplementation on weight loss, lipid profiles, high-sensitivity C-reactive protein (hs-CRP), and glucose levels in patients with coronary artery disease (CAD). A systematic search was performed using various online databases, including Scopus, PubMed, Web of Science, EMBASE, and Cochrane Library, to identify relevant randomized controlled trials (RCTs) until June 2023. To evaluate heterogeneity among the selected studies, the Q-test and I2 statistics were employed. Data were combined using either a fixed- or random-effects model and presented as a weighted mean difference (WMD) with a 95% confidence interval (CI). Of the 428 citations, six RCTs were included. The pooled results did not show significant changes in the WMD of lipid factors (high-density lipoprotein cholesterol, triglycerides (TG), low-density lipoprotein cholesterol, and total cholesterol) following flaxseed intake. However, after performing a sensitivity analysis to determine the source of heterogeneity, flaxseed supplementation resulted in a significant decrease in TG levels (WMD = -18.39 mg/dL; 95% CI: -35.02, -1.75). Moreover, no significant differences were observed in either weight or BMI following flaxseed intake. However, the circulating levels of fasting blood glucose (WMD = -8.35 mg/dL; 95% CI: -15.01, -1.69, p = .01) and hs-CRP (WMD = -1.35 mg/L; 95% CI: -1.93, -0.77, p < .01) significantly decreased after the intervention. Flaxseed supplementation was associated with lowering FBS, hs-CRP, and TG levels but did not affect weight loss parameters and other lipid markers in CAD.

Clinical effects of anodal tDCS and identifying response markers in post-traumatic stress disorder (PTSD): An open-label study.

Transcranial direct current stimulation (tDCS) is a promising treatment for post-traumatic stress disorder (PTSD). However, not all patients respond to this type of treatment. The first aim of present study was to examine efficacy of tDCS for PTSD, depression, anxiety, and anhedonia in patients with PTSD. The second aim of this study was to examine the demographic, clinical, and psychological factors that may predict response to tDCS. In this open-label study, 103 PTSD patients underwent 10 sessions of tDCS (2 mA, 20 min). The anodal and cathodal electrodes were placed over the left dorsolateral prefrontal cortex (DLPFC; F3) and right supra-orbital (FP2) Respectively. Clinical outcome measures included Posttraumatic the Stress Disorder Checklist for DSM-5 (PCL-5), the Beck Depression Inventory (BDI-II), the Beck Anxiety Inventory (BAI), and the Snaith-Hamilton Pleasure Scale (SHAPS). There was an overall significant improvement in symptoms of PTSD, depression, anxiety, and anhedonia from pre- to post-treatment. Results also revealed that non-responders had higher severity at baseline for depression, anxiety, and anhedonia. However, higher severity of depression and anhedonia at baseline predicted response status, with higher severity associated with greater likelihood of non-response. tDCS of the left dLPFC and right supra-orbital appears to have a positive effect in reducing PTSD and related symptoms. These initial results could have an important influence on the adoption of anodal tDCS over the left DLPFC for PTSD, by enabling the early identification of patients who respond to tDCS.

tDCS efficacy and utility of anhedonia and rumination as clinical predictors of response to tDCS in major depressive disorder (MDD).

BACKGROUND: Anhedonia and rumination are mental disorders' transdiagnostic features but remain difficult to treat. Transcranial direct current stimulation (tDCS) is a proven treatment for depression, but its effects on anhedonia and rumination and whether anhedonia and rumination can be used as a predictive biomarker of treatment response is not well known. This study aimed to investigate the tDCS efficacy and identify the predictive role of anhedonia and rumination in response to tDCS in patients with MDD. METHODS: 182 patients received 10 tDCS sessions delivered at 2 mA to left (anode) dorsolateral prefrontal cortex (DLPFC). Hamilton Rating Scale for Depression (HRSD-17), Snaith-Hamilton Pleasure Scale (SHAPS), and the 10-item Ruminative Response Scale (RRS-10) was administered to patients with MDD before treatment, following it, and after two weeks of tDCS. RESULTS: There was an overall significant improvement in anhedonia from pre- to post-treatment. Regression analyses revealed that responders had higher baseline anhedonia and rumination (reflective pondering) scores. We found that the reduction in HRSD scores after tDCS was significantly associated with anhedonia's baseline values while no relation was found between baseline rumination and tDCS treatment response. CONCLUSION: These results provide new evidence that pronounced anhedonia may be a significant clinical predictor of response to tDCS. Patients with severe or low baseline rumination had an equal chance of achieving clinical response. Prospective tDCS studies are necessary to validate the predictive value of the derived model.

Relationship between job stress and work-related quality of life among emergency medical technicians: a cross-sectional study.

OBJECTIVE: This study was aimed to determine the relationship between job stress and work-related quality of life (WRQoL) among emergency medical technicians (EMTs) in Lorestan province, Western Iran. DESIGN: This was a cross-sectional study. METHODS: Totally 430 EMTs who had been engaged in their respective units for more than 6 months from all emergency facilities in Lorestan province were selected using single stage cluster sampling method. Data were collected from April to July 2019 using two standard questionnaires: job stress (Health and Safety Executive (HSE)) and WRQoL. The OR with 95% CI was used to declare the statistical association (p≤0.05). RESULTS: All participants were exclusively males, with a mean age of 32±6.87 years. The overall average score of job stress using the HSE scale was 2.69±0.43; while the overall quality of working life score was 2.48±1.01. The type of working shift was found to have a significant impact on the HSE-average score (F(3,417)=5.26, p=0.01); and on the WRQoL-average score (F(3,417)=6.89, p<0.01). CONCLUSION: Two-thirds of EMTs working in governmental hospitals had job stress and a low quality of work-related life. Additionally, work shift was statistically significant associated with EMTs' job stress and WRQoL.

Characterization of left ventricular diastolic parameters of gated-single-photon emission computed tomography myocardial perfusion imaging in patients with diabetes and normal myocardial perfusion and systolic function.

BACKGROUND: Diabetic cardiomyopathy is defined as an independent entity with a specified pathological progression from diastolic dysfunction with preserved ejection fraction to overt heart failure. Myocardial perfusion imaging (MPI) with gated-single-photon emission computed tomography (G-SPECT) has been introduced as a feasible tool to evaluate left ventricular (LV) diastolic function. The aim of this study was to investigate the characteristics of diastolic parameters derived from G-SPECT MPI in diabetic patients compared to patients at very low risk of coronary artery disease (CAD) and with no other CAD risk factors. METHODS: This cross-sectional study was performed on patients referred to the nuclear medicine department for G-SPECT MPI. Demographic and clinical data, as well as medical history, were extracted from a digital registry system including 4447 patients. Then, two matched groups of patients with only diabetes as cardiac risk factor ( n = 126) and those without any identifiable CAD risk factors ( n = 126) were selected. Diastolic parameters of MPI, including peak filling rate, time to peak filling rate, mean filling rate at the first third of diastole and second peak filling rate, were derived using quantitative software for eligible cases. RESULTS: The mean age of the diabetic and nondiabetic groups was 57.1 ± 14.9 and 56.7 ± 10.6 years, respectively ( P = 0.823). Comparison of quantitative SPECT MPI parameters between the two groups showed a statistically significant difference only in total perfusion deficit scores, whereas none of the functional parameters, including diastolic and dyssynchrony indices and the shape index, were significantly different. There were also no significant differences in diastolic function parameters between diabetes and nondiabetes patients in the age and gender subgroups. CONCLUSION: Based on the G-SPECT MPI findings, there is a comparable prevalence of diastolic dysfunction in patients with only diabetes as a cardiovascular risk factor and low-risk patients with no cardiovascular risk factors in the setting of normal myocardial perfusion and systolic function.

Effect of the chronic medication use on outcome measures of hospitalized COVID-19 patients: Evidence from big data.

Background: Concerns about the role of chronically used medications in the clinical outcomes of the coronavirus disease 2019 (COVID-19) have remarkable potential for the breakdown of non-communicable diseases (NCDs) management by imposing ambivalence toward medication continuation. This study aimed to investigate the association of single or combinations of chronically used medications in NCDs with clinical outcomes of COVID-19. Methods: This retrospective study was conducted on the intersection of two databases, the Iranian COVID-19 registry and Iran Health Insurance Organization. The primary outcome was death due to COVID-19 hospitalization, and secondary outcomes included length of hospital stay, Intensive Care Unit (ICU) admission, and ventilation therapy. The Anatomical Therapeutic Chemical (ATC) classification system was used for medication grouping. The frequent pattern growth algorithm was utilized to investigate the effect of medication combinations on COVID-19 outcomes. Findings: Aspirin with chronic use in 10.8% of hospitalized COVID-19 patients was the most frequently used medication, followed by Atorvastatin (9.2%) and Losartan (8.0%). Adrenergics in combination with corticosteroids inhalants (ACIs) with an odds ratio (OR) of 0.79 (95% confidence interval: 0.68-0.92) were the most associated medications with less chance of ventilation therapy. Oxicams had the least OR of 0.80 (0.73-0.87) for COVID-19 death, followed by ACIs [0.85 (0.77-0.95)] and Biguanides [0.86 (0.82-0.91)]. Conclusion: The chronic use of most frequently used medications for NCDs management was not associated with poor COVID-19 outcomes. Thus, when indicated, physicians need to discourage patients with NCDs from discontinuing their medications for fear of possible adverse effects on COVID-19 prognosis.

Morphological diversity of indigenous wild pomegranate (Punica granatum L. var. spinosa) accessions from northeast of Iran.

Wild pomegranate is a valuable edible species in the plant ecosystem of the Hyrcanian forests and the northern plains of the Caspian coast in Iran. The genetic diversity of these wild pomegranates can be effective in pomegranate breeding programs and germplasm conservation. In the present study, morphological diversity in 103 wild pomegranates (Punica granatum L. var. spinosa) in the northeastern area of Iran was studied using 46 traits related to trees, flowers, and fruits. The results showed that the fruit weight ranged from 17.93 to 99.9 g with an average of 48.92 g, the total aril weight ranged from 0.54 g to 64.78 g with an average of 24.25 g, and the weight of 100 arils was between 4.89 and 46.21 with an average of 13.79. The fruit cracking percent, crown shape, aril juiciness, calyx, and corolla colors show a high coefficient of variation (CV > 70%). Based on PCA results, fruit weight and total aril weight, peel weight, and fruit length and diameter were important on determining differences among accessions. In biplot analysis, genotype distribution was determined by two main factors. In cluster analysis, the studied accessions were divided into two different major clusters and two subclusters in each one. The results showed a high diversity of important pomological traits in wild pomegranates such as fruit weight, fruit cracking percent, crown shape, total aril weight, aril juiciness corolla, and calyx color that can be used in breeding programs to improve pomegranate juice quality and marketability.

Risk Mapping and Spatial Modeling of Human Cystic Echinococcosis in Iran from 2009 to 2018: A GIS-Based Survey.

Background: Cystic echinococcosis (CE) is one of the most important parasitic infections in subgroup seven common neglected diseases of humans and animals. It is in the list of 18 neglected tropical diseases of the WHO. We aimed to analyze the situation of the disease in Iran using Geographical Information System (GIS) and satellite data analysis. Methods: The data obtained from the Ministry of Health and Medical Education, Tehran, Iran and other related centers from 2009 to 2018 were analyzed using GIS. Then, the spatial distribution maps of the disease were generated, and the hot spots of the disease in Iran were determined using spatial analysis of ArcGIS10.5 software. Geographically weighted regression (GWR) analysis in ArcGIS10.5 was used to correlate the variables affecting the disease including temperature, relative humidity, normalized different vegetation index (NDVI) and incidence of hydatidosis. Data analysis was performed by Linear regression analysis and SPSS 21 software using descriptive statistics and chi-square test. Results: Zanjan, Khorasan Razavi, North Khorasan, Chaharmahal Bakhtiari, Hamedan, Semnan, and Ardabil provinces were the hot spots of CE. The results of geographical weighted regression analysis showed that in Khorasan Razavi, North Khorasan, Chaharmahal Bakhtiari, Hamedan, Semnan, Ardabil, Zanjan, Qazvin, and Ilam provinces, the highest correlation between temperature, humidity, vegetation density and the incidence of hydatidosis was observed (P<0.001). Conclusion: The use of maps could provide reliable estimates of at-risk populations. Climatic factors of temperature, humidity, NDVI had a greater impact on the probability of hydatidosis. These factors can be an indicator used to predict the presence of disease. Environmental and climatic factors were associated with echinococcosis.

Assessing the Role of Urban Green Areas for Students' Quality of Life during the COVID-19 Pandemic.

Background: The COVID-19 pandemic and social distancing measures have limited outdoor activities for many people, including university students who live inside the campus and far from their families. We investigated if and how the fear of COVID-19 had impacted visiting green areas and consequently the quality of life. Methods: The assessments were taken through a questionnaire-based survey of the university students living inside the campus in two universities (Konkuk and Sejong universities) in Seoul, South Korea in 2021 (n=255). Measuring three variables, the participants were asked to self-estimate their fear of COVID-19 and quality of life during the pandemic, and the time and frequency of the park visit. Structural equation modeling (SEM) and confirmatory factor analysis (CFA) were conducted to explore the potential relationship between the three main observed variables. Results: In the case of the campus students, visiting the green area cannot play a mediating impact on the effect of the COVID-19 fear and quality of life. Likewise, the data did not support the effect of COVID-19 fear on the quality of life for this group of students, however, significant correlations were found between the COVID-19fear and visiting green spaces (P<0.05) (positive effect on visiting, and negative effect on the time of visit). Conclusion: Students perceived not a considerable improvement in their quality of life after visiting green areas. It might be due to the fear of staying outdoor for a long time (frequency) during the pandemic, and students' lifestyles. However, the quality of life for the students is likely to be influenced by other factors, rather than the fear of COVID-19.

Comparison of Immediate Effect of New Knee brace and Conventional Three-Points Knee Valgus Brace on Knee Adduction Moment and ROM in Patients with Medial Knee Osteoarthritis.

The knee unloader brace can change loading on knee which may be effective in reducing symptoms and progression of disease in people with knee osteoarthritis. The purpose of this study was to evaluate the effect of a new knee brace during walking in a patient with medial compartment knee osteoarthritis. Two brace types were used: new brace and conventional brace. A pneumatic cuff of novel brace was fitted in the bottom of the medical slipper that was connected to the cuff section of the knee through the tube. After the knee brace is deployed, its force can vary in different stages of the gait. During the heel strike, the weight of the cuff is compressed on the floor, causing the air to flow inside it and entering the volume of air into the knee pad. The results of using this pneumatic knee brace compared with conventional knee braces on a patient showed that in both cases, the open and closed palatal pump, the adduction moment and ROM was decreased in the stance phase. But the three-point knee pressure, however, was less effective in reducing the adduction moment but also reduced the knee ROM. Using novel brace can eliminate the patient's need for painful and costly surgery to reduce the symptoms of osteoarthritis.

Folic Acid-Decorated pH-Responsive Nanoniosomes With Enhanced Endocytosis for Breast Cancer Therapy: In Vitro Studies.

Breast cancer is the most common invasive cancer in women and the second leading cause of cancer death in women after lung cancer. The purpose of this study is a targeted delivery toward in vitro (on MCF7 and 4T1 breast cancer cell lines) through niosomes-based nanocarriers. To this end, different bioactive molecules, including hyaluronic acid (HA), folic acid (FA), and polyethylene glycol (PEG), were used and compared for surface modification of niosomes to enhance endocytosis. FA-functionalized niosomes (Nio/5-FU/FA) were able to increase cell cytotoxicity and reduce cell migration and invasion compared to PEG-functionalized niosomes (Nio/5-FU/PEG), and HA-functionalized niosomes (Nio/5-FU/HA) groups in MCF-7 and 4T1 cell lines. Although the Nio/5-FU/PEG and Nio/5-FU/HA demonstrated MCF7 cell uptake, the Nio/5-FU/FA exhibited the most preponderant endocytosis in pH 5.4. Remarkably, in this study 5-FU loaded niosomes (nonionic surfactant-based vesicles) were decorated with various bioactive molecules (FA, PEG, or HA) to compare their ability for breast cancer therapy. The fabricated nanoformulations were readily taken up by breast cancer cells (in vitro) and demonstrated sustained drug release characteristics, inducing cell apoptosis. Overall, the comprehensive comparison between different bioactive molecules-decorated nanoniosomes exhibited promising results in finding the best nano formulated candidates for targeted delivery of drugs for breast cancer therapy.

The Effects of Combining High-Top Shoes with Twister Wrap Orthoses on Balance Parameters of Children with Spastic Diplegic Cerebral Palsy.

BACKGROUND: Cerebral palsy (CP) is a non-progressive encephalopathy before, during, or after childbirth with almost the most common type, i.e. spastic diplegic, leading to a frequent walking problem, In-toeing. Orthoses can reduce the consequences of CP. OBJECTIVE: This study aimed to evaluate the effect of combining twister wrap orthoses (TWO) with high-top shoes on the balance parameters of children with spastic diplegic CP. MATERIAL AND METHODS: In this quasi-experimental study, twenty children (aged 6.8 ± 0.5 years) with spastic diplegic CP with in-toeing gait participated. The tests were conducted in three conditions: 1) in bare-foot, 2) with high-top shoes, and 3) with high-top shoes plus TWO and the orthoses effects on balance parameters were compared. RESULTS: High-top shoes positively decreased center of pressure (COP) sway in the anterior-posterior (AP) direction. Both high-top shoes and high-top shoes with TWO conditions compared to bare-foot conditions significantly improved standing balance by decreasing the ellipse area. Pairwise, wearing TWO and high-top shoes significantly reduced the COP sway in the medial-lateral (ML) and AP directions with a significant difference between using the combined orthoses and the shoe without TWO in ML of COP displacement. CONCLUSION: High-top shoes alone and the combination of high-top shoes with TWO conditions may enhance the stability of children with spastic diplegia more than barefoot. Although the use of combined orthoses induced significant improvement in the ML direction of COP displacement.

Assessing the Correlation between Neighborhood Green Areas and the Perceived Mental Health of Residents in Metropolitan Areas.

Background: Urban parks play a noticeable role in city areas for making connections between nature and the residents of cities, especially from a mental health perspective. This paper investigated how the number and types of urban parks impact city residents' mental health. Method: This study used the data collected by the Community Health Survey in Seoul, South Korea in 2020 (n=22915). The type and number of local parks were categorized based on each district, and three variables of mental health were selected, including 'subjective health awareness', 'stress awareness' and 'depression rate'. Correlation and interaction analyses were conducted to explore the relationship between variables. Result: The data indicated that both the quantity and types of the urban parks were associated with mental health of the residents. Positive mental health is likely to be associated with higher density of local parks in a district. It seems that parks characterized by children's activity and have nature-focused design, are more effective in changing the mental health of residents. Discussion: The research demonstrates a positive relationship between the quantity of urban parks and mental health in the scale of city districts. However, such a correlation can differ based on the type of parks, as well as the quantity of greenery in an area.

Analyzing the Impact of Green Roof Functions on the Citizens' Mental Health in Metropolitan Cities.

BACKGROUND: The fast-growing trend of urbanizations and the dwellers' stressful lifestyle in megacities has led to several drawbacks from the mental health perspective. Provided that there is a significant association between the green environment and mental health, we investigated different functions of a green roof from two perspectives of well-being and environment. METHODS: After investigating on different functions of the green roof and classifying them into two sections, a self questionnaire survey was conducted in May 2020 on 100 citizens of the Seoul metropolitan area after, South Korea visiting the green roof. They were asked to clarify their perception of the different functions of green roof gardens. The statistical analysis was performed to show the differences in perception and how each variable can contribute to such differences. RESULTS: The results illustrated a high satisfaction rate among the visitors of green roofs. The perception of the well-being functions was higher than those of environmental functions. However, age group can alter the perception significantly, as the senior citizens significantly perceived the well-being functions. In contrast, the awareness of the environmental functions was higher among the younger participants. CONCLUSION: Providing practical information about the ideal functions of green roofs, this study offered helpful insight for the planners who focus on society's general health and work in two different sections: developing the city landscape and mental health improvement.

Comparison of electronic versus conventional assessment methods in ophthalmology residents; a learner assessment scholarship study.

BACKGROUND: Assessment is a necessary part of training postgraduate medical residents. The implementation of methods located at the "shows how" level of Miller's pyramid is believed to be more effective than previous conventional tools. In this study, we quantitatively compared electronic and conventional methods in assessing ophthalmology residents. METHODS: In this retrospective study, eight different conventional methods of assessment including residents' attendance, logbook, scholarship and research skills, journal club, outpatient department participation, Multiple Choice Question (MCQ), Objective Structured Clinical Examination (OSCE), and professionalism/360-degree (as one complex) were used to assess 24 ophthalmology residents of all grades. Electronic media consisting of an online Patient Management Problem (e-PMP), and modified electronic OSCE (me-OSCE) tests performed 3 weeks later were also evaluated for each of the 24 residents. Quantitative analysis was then performed comparing the conventional and electronic assessment tools, statistically assessing the correlation between the two approaches. RESULTS: Twenty-four ophthalmology residents of different grades were included in this study. In the electronic assessment, average e-PMP scores (48.01 ± 12.40) were much lower than me-OSCE (65.34 ± 17.11). The total average electronic score was 56.67 ± 11.28, while the total average conventional score was 80.74 ± 5.99. Female and male residents' average scores in the electronic and conventional method were (59.15 ± 12.32 versus 83.01 ± 4.95) and (55.19 ± 10.77 versus 79.38 ± 6.29), respectively. The correlation between modified electronic OSCE and all conventional methods was not statistically significant (P-value >0.05). Correlation between e-PMP and six conventional methods, consisting of professionalism/360-degree assessment tool, logbook, research skills, Multiple Choice Questions, Outpatient department participation, and Journal club active participation was statistically significant (P-value < 0.05). The overall correlation between conventional and electronic methods was significant (P-value = 0.017). CONCLUSION: In this study, we conclude that electronic PMP can be used alongside all conventional tools, and overall, e-assessment methods could replace currently used conventional methods. Combined electronic PMP and me-OSCE can be used as a replacement for currently used gold-standard assessment methods, including 360-degree assessment.

Clinical and demographic predictors of response to anodal tDCS treatment in major depression disorder (MDD).

Transcranial direct current stimulation (tDCS) of the prefrontal cortex is known as a promising intervention in major depression disorder (MDD). However, limited information on predictors of therapeutic response to tDCS are available. This study aimed to investigate clinical and demographic predictors of therapeutic response in patients taking no medications. For this purpose, the required data were collected from 2 independent tDCS trials on 116 MDD patients. Accordingly, 84 patients underwent 10 sessions of 2 mA tDCS daily each one lasted for 20 min and 32 patients received 10 twice sessions of 2 mA tDCS daily each one lasted for 20 min. Anodal electrode was located over the left dorsolateral prefrontal cortex (DLPFC), and cathode was over the right supraorbital region. Depression symptoms and the underlying clinical dimensions were assessed using the Beck Depression Inventory (BDI-II) at baseline and after the tDCS treatment. Of the included 116 patients, 47.4% showed an antidepressant response. Results of logistic regression analysis showed that the reduction in BDI-II scores after tDCS was associated with the baseline values of cognitive-affective symptoms factor, loss of pleasure, loss of interest, and sleep problems. Pronounced sleep disturbances and cognitive-affective symptoms were identified as the potential clinical predictors of response to tDCS. However, more prospective tDCS studies are necessary to validate the predictive value of the derived model.